Myocardial Protection in Adults

Abstract

The use of cardioplegia solution has resulted in substantial improvements in safety and efficacy of cardiac surgery procedures. Its main aims are to protect the myocardium by inducing a cardioplegic diastolic arrest, reducing myocardial energy wasting, preventing cellular damage during the ischemia period and minimizing reperfusion injury after restoration of blood flow in the coronary arteries. This chapter provides an overview of the scientific evidence about cardioplegia as well as describes the daily practice of myocardial protection during cardiac operations. The basic principles of myocardial ischemia and reperfusion injury and how they impact on myocardial protection are discussed. Different types of cardioplegic methods, composition of cardioplegic solutions, strategies and timing of cardioplegic delivery along with adjuncts for cardioplegic solutions are also presented.